Basic Information
| Provider Information | |||||||||
| NPI: | 1669455861 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THAUNG | ||||||||
| FirstName: | MEHM | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 751069 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282751069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527443253 | ||||||||
| FaxNumber: | 2527443194 | ||||||||
| Practice Location | |||||||||
| Address1: | CHOWAN MEDICAL CENTER | ||||||||
| Address2: | 201 VIRGINIA ROAD | ||||||||
| City: | EDENTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524822116 | ||||||||
| FaxNumber: | 2524826274 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2005 | ||||||||
| LastUpdateDate: | 01/22/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 200201633 | NC | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00002730 | 01 | NC | RAILROAD MEDICARE | OTHER | 89133EY | 05 | NC | MEDICAID | 133EY | 01 | NC | BCBS NC | OTHER |